Current diabetes reviews最新文献

The recent discovery of feimin, a feeding-induced myokine modulating glucose homeostasis via the MERTK pathway, offers a novel therapeutic avenue for metabolic disorders. While other studies delineate its acute metabolic effects in Han Chinese populations, critical gaps remain in understanding its mechanistic interplay, population generalizability, and long-term impacts. This perspective synthesizes current evidence, highlights limitations in study design and translational applicability, and proposes integrative approaches, spanning multi-omics, global consortia, and interventional trials, to unravel feimin's role in metabolic regulation. By addressing these challenges, feimin may emerge as a biomarker or therapeutic target for diabetes and related syndromes.

Background: Epigenetic regulation constitutes critical molecular mechanisms underlying the pathogenesis of diabetes and disease progression. While substantial mechanistic investigations exist, the field lacks systematic mapping of research trends, collaborative networks, and emerging frontiers.

Objectives: To conduct the first comprehensive bibliometric evaluation of epigenetic studies in diabetes mellitus and its complications (2014-2024), identifying key research domains, international collaboration patterns, and innovative investigative directions to inform strategic research planning and highlight opportunities for innovative therapeutic approaches.

Methods: We interrogated the Web of Science Core Collection using stringent inclusion criteria, analyzing 1,451 publications through advanced multi-dimensional metrics in CiteSpace (6.2.R4), VOSviewer (1.6.20), and Bibliometrix (4.1.3).

Results: A total of 1,451 original and review articles were retrieved, involving 83 countries/regions, 576 journals, and 7,645 authors. The United States produced the highest number of publications (n = 464), followed by China (n = 283) and Italy (n = 121). The International Journal of Molecular Sciences was the leading journal (66 publications), dominated by review articles (n = 53). Author collaboration networks were extensive, with Charlotte Ling emerging as the most prolific and influential author in publications, citations, and H-index. Keyword co-occurrence analyses emphasized type 2 DM, gestational DM, and diabetic nephropathy as primary research focuses, while new frontiers highlighted potential links to Alzheimer's disease and fibroblast biology.

Conclusion: This multi-dimensional analysis provides quantitative visualization of research evolution, delineates current investigative priorities, and highlights underexplored therapeutic targets. Our findings establish a strategic framework for transdisciplinary collaboration in precision diabetology.

Diabetes mellitus (DM) is a growing global health concern, placing increasing strain on healthcare systems. Curcumin, the primary bioactive compound in Curcuma longa (turmeric), has been reported to exhibit several therapeutic effects, including potential benefits for managing DM. However, its clinical use is limited by poor bioavailability. Nanotechnology, particularly nano-curcumin (nCUR), offers a promising solution by enhancing curcumin's delivery and effectiveness. Preclinical and clinical studies suggest that nCUR may help manage DM and its complications by reducing oxidative stress, genotoxicity, and mitochondrial dysfunction. Despite these promising results, the exact molecular mechanisms of nCUR remain unclear, and clinical evidence is still limited. Furthermore, there is a lack of global guidelines regulating the use of nanomaterials in medicine. In summary, while nCUR shows strong potential as a therapeutic option for diabetes, further research is necessary to elucidate its mechanisms, confirm its clinical efficacy and safety, and establish standardized guidelines for its use in healthcare.

Diabetic wounds constitute a significant global health challenge, affecting millions of individuals worldwide and imposing a substantial burden on healthcare systems. This review explores the complex pathophysiology of diabetic wound healing and discusses innovative interventions aimed at addressing this critical clinical problem. The impaired healing process in diabetic wounds is characterized by a multitude of interrelated factors, including cellular dysfunction, altered inflammatory responses, oxidative stress, the formation of advanced glycation end-products, and neurovascular abnormalities. Fibroblasts, keratinocytes, and endothelial cells demonstrate diminished proliferation and migration capabilities, while immune cells exhibit dysregulated responses, which contribute to a persistent inflammatory state. Complications associated with diabetes, such as neuropathy and vascular insufficiency, further exacerbate the wound healing process. Recent advancements in wound care strategies have opened new avenues for enhancing diabetic wound healing. These advancements encompass the development of advanced dressings and biomaterials, growth factor therapies, cell-based interventions, and gene therapy approaches. The integration of diverse treatment modalities, coupled with the management of systemic metabolic abnormalities, offers significant promise for improving outcomes in diabetic wound care. Future research should focus on optimizing combination therapies, developing personalized treatment algorithms, and conducting large-scale clinical trials to establish the most effective and safest interventions for diabetic wound healing.

Background: Although insulin is essential for managing type 1 diabetes and is life-saving for patients with this condition, some individuals may intentionally reduce or omit insulin due to a fear of weight gain or a desire to lose weight. This behavior is commonly referred to as diabulimia.

Methods: Since diabulimia is not formally defined, a systematic review of the limited literature was conducted on November 8th, 2024, using PubMed, Scopus, and Web of Science databases. The search terms included "diabulimia", "insulin omission", "insulin restriction", "eating disorders", "disordered eating", and "type 1 diabetes". Out of 288 manuscripts, 19 were selected after excluding non-English articles and screening the titles and abstracts.

Results: Eating disorders and disordered eating are common in patients with type 1 diabetes, often driven by concerns regarding body image and weight. These behaviors can complicate diabetes management, worsen glucose control, and increase the risk of complications. Diabulimia may develop as a coping mechanism, especially in adolescents with higher body mass index and a history of eating disorders. Diagnosis is challenging due to the lack of established guidelines, but poor glucose control can raise suspicion and prompt further psychological evaluation. A multidisciplinary approach, combining medical care, nutrition, mental health support, and therapy, is recommended, despite limited evidence.

Conclusion: While diabulimia is not formally recognized, understanding its impact can help healthcare professionals diagnose and manage it more effectively, improving patients' health and well-being.

Aims: Preclinical Evaluation of Fisetin in the Management of Diabetic Foot Ulcer in Wistar Rats.

Introduction: Diabetic foot ulcer (DFU) is a complication of diabetes mellitus, often leading to non-traumatic amputations and significantly impacting patient morbidity. Globally, the prevalence of DFU ranges from 9.1 to 26.1 million annually. A 2022 meta-analysis revealed that 6.3% of diabetic adults (33 million) are affected by DFUs. The current treatments primarily focus on topical treatments, neglecting the underlying metabolic conditions.

Objective: To investigate the wound healing efficacy of the phytoconstituent fisetin, administered orally, in managing DFU in diabetic neuropathic Wistar rats.

Method: This study investigates the therapeutic potential of a phytoconstituent fisetin, in the management of wound healing in STZ-NAD induced diabetic animal model with surgically induced wounds after indication of neuropathy. Fisetin was administered orally at doses of 5, 10, and 15 mg/kg for 30 days following the induction of foot ulcers, Various parameters were measured, including blood glucose levels, HbA1c, lipid profile, pro-inflammatory cytokines, antioxidant activity, MDA, and histopathological analysis of wound healing.

Result: Fisetin, particularly at 15 mg/kg, significantly modulates blood glucose level, HbA1c, lipid profile, and pro-inflammatory cytokines, further enhancing antioxidant activity, while reducing MDA, indicating a reduction in oxidative stress. Histopathological analysis demonstrated enhanced wound healing by increased fibroblast proliferation and collagen formation, as well as restoration of the epithelial layer. Fisetin also exhibited potential in enhancing re-epithelization, enhancing pro-angiogenic markers, diminishing inflammation, and reducing wound size.

Conclusion: Fisetin demonstrates promising potential in managing DFU by modulating metabolic conditions, reducing blood glucose, oxidative stress, and inflammation, and promoting wound healing. Future studies should focus on unraveling the detailed molecular pathways involved in fisetin's action, along with clinical trials to validate its efficacy in DFU patients.

Type 2 diabetes mellitus (T2DM) remains one of the most prevalent chronic metabolic disorders globally, presenting an ongoing challenge in terms of prevention and management. The majority of existing therapeutic strategies focus primarily on glycemic control. However, the role of inflammation in the pathogenesis of the disease is being recognized increasingly, which has brought to light a critical gap in our understanding of diabetes treatment in the context of anti-inflammatory therapeutics. Inflammatory reactions are essential to the development and progression of T2DM. The NLRP3 inflammasome, along with its downstream inflammatory factors, is a key mediator of these responses. Recent data underscore the significance of Interleukin- 1β (IL-1β) in instigating and sustaining inflammation-related organ dysfunction in T2DM. Consequently, factors governing NLRP3 activation and IL-1β expression emerge as potential therapeutic targets. Here, we aim to examine one such therapeutic agent, colchicine, which can potentially manage inflammation associated with T2DM. As an anti-inflammatory medicine, colchicine can inhibit the assembly and activation of the NLRP3 inflammasome via various mechanisms, thereby mitigating inflammation. In this context, the study discusses the mechanisms that link metabolic disorders with the onset of chronic inflammation, evaluates clinical studies and trials that investigate the efficacy and safety of colchicine, as well as discusses its benefits and limitations as an anti-inflammatory therapy in T2DM. The goal is to provide a clear framework for understanding the role of colchicine in the therapeutic landscape of T2DM, potentially leading to novel approaches for managing the disease.

Introduction: Type 2 Diabetes Mellitus (T2DM) is the most prevalent form of hyperglycemia, often coexisting with Non-Alcoholic Fatty Liver Disease (NAFLD), as both share disrupted glucose and lipid metabolic pathways. The study aimed to explore the antidiabetic and hepatoprotective potential of active phytoconstituents from Tinospora cordifolia, Phyllanthus niruri, and Picrorhiza kurroa, focusing on their interaction with GPR120 and GPR 40 receptors through network pharmacology and molecular docking approaches.

Method: A combined extract of T. cordifolia, P. niruri, and P. kurroa was prepared following the Ayurvedic pharmacopoeia standards. Phytoconstituents were identified using High-Performance Thin-Layer Chromatographic (HPTLC) and mass spectroscopy. Network pharmacology analysis predicted mechanisms of action involving PI3-kinase, Protein Kinase C, and PI3K-Akt signaling pathways, targeting GPR120 and GPR40. Molecular docking was conducted for 31 identified compounds, and pharmacokinetic (ADMET) properties of the key hits were evaluated.

Results: Molecular docking identified six compounds with strong binding affinities to GPR 120 and 40. Among these, ferulic acid, caffeic acid, and cinnamic acid exhibited significant binding to GPR40 with docking scores of -10.68, -9.991, and -7.580 kcal/mol, respectively. Similarly, veronicoside, malic acid, and corilagin demonstrated strong interaction with GPR120, with docking scores of -8.95, -7.32, and -9.21 kcal/mol. The combined extract contained cinnamic acid and corilagin as major phytoconstituents, supported by favourable ADMET properties. The analysis highlighted their role in modulating glucose and lipid metabolism via key signaling pathways, corroborating their antidiabetic and hepatoprotective potential.

Conclusion: his study identifies cinnamic acid and corilagin as promising candidates for natural therapeutics targeting T2DM and NAFLD. The translational potential of T. cordifolia, P. niruri, and P. kurroaprovide further experimental validation to confirm their clinical efficacy in modulating metabolic pathways.

Diabetic wounds are a class of chronic wounds that exhibit significant healing abnormalities due to dysregulated cytokines, growth factors, and unique cellular expressions, currently affecting an estimated 9.1-26.1 million people per year globally. Matrix metalloproteinases (MMPs), angiogenic factors, and inflammatory mediators remain the key determinants for managing diabetic wounds. Vascular endothelial growth factor (VEGF) is one of the most prominent types of growth factors induced during angiogenesis in general and cell proliferation pathways. Chronic hyperglycemia, neuropathy, and inflammation associated with diabetes disorders affect cellular responses, blood circulation, and immunological systems impair normal wound healing. This reduced effectiveness of current management strategies is reflected in the high number of delayed wounds among diabetic patients due to escalated oxidative stress and impaired signaling pathways, which prevent healing, calling for new therapies. MMPs are essential for tissue remodeling, but excess levels of MMPs predispose tissues to matrix degradation and interruption in cell signaling leading thereby prolonging inflammation seen in diabetic wounds. Efficient wound healing requires a balanced relationship regarding matrix metalloproteinases and tissue inhibitors of metalloproteinases (TIMPs). New regenerative solutions, such as stem cells, platelet-rich plasma (PRP), gene therapies, and MMP inhibitors that can re-establish angiogenesis; decrease inflammation; and stimulate growth factor signaling, suggest promising strategies for improved diabetic wound healing. Hyperbaric oxygen therapy allows tissue regeneration and reduces the area of ulceration, bringing other benefits. In the future, therapeutics should focus on multifunctional and responsive strategies that include anti-inflammatory agents, cytokine modulators, and stem cell treatments that exhibit superior efficacy in comparison to conventional therapies when assessed clinically. Novel advanced combination strategies represent a realistic route to targeted therapies that meet clinical needs and have the potential capability for utilizing mechanistic insights, both creative in their implementation of recently developed techniques as well as applied on a broader scale through the evidence-based management across diabetic wounds offering better outcomes and quality of life amongst increasing diabetic commonalities.